Positive urinary cytology in patients with lung cancer in the absence of obvious urine tract metastases |
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Authors: | Voulgaris E Pentheroudakis G Pappa L Bafa M Goussia A Dalezis P Tsombanidou C Geromichalos G Papageorgiou A Koutsilieris M Malamou-Mitsi V Pavlidis N |
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Affiliation: | a Department of Medical Oncology, Ioannina University Hospital, Ioannina, Greece b Department of Pathology-Cytopathology, Ioannina University Hospital, Greece c Laboratory of Experimental Chemotherapy, Laboratory of Cell Culture - Molecular Modeling and Drug Design, Theagenion Cancer Hospital, Thessaloniki, Greece d Department of Pathology, Theagenion Cancer Hospital, Thessaloniki, Greece e Laboratory of Experimental Physiology, Athens School of Medicine, Athens, Greece |
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Abstract: | PurposeTo study the phenomenon of positive urine cytology in patients with lung cancer in the absence of obvious urothelial metastases.Patients and methods150 patients with small (SCLC) and non-small cell lung cancer (NSCLC) of all stages and 3 control groups were prospectively studied. Immunocytochemical study (cytokeratins 7-20, TTF1) in all positive urine specimens and chemokine profile (CXCR4, CCL21) study of the primary tumor in selected positive patients was performed. In experimental study, C57Bl/6 BALB/C mice injected with LLC lung and 4T1 mammary cancer cells were used for the detection of positive urine cytology.Results11% of patients with NSCLC, 7% of patients with SCLC and none of the control group had positive urine cytology. In NSCLC, metastatic disease and high tumor burden positively correlated (p = 0.01 and 0.03 respectively) with the phenomenon. In SCLC, correlation with extensive disease and multiple metastatic sites (p = 0.02 and 0.04 respectively) was found. No correlation was found in either group with: age, gender, histology, performance status, line of chemotherapy, previous platinum-based chemotherapy, adrenal metastases, renal function, abnormal urinary sediment, response to chemotherapy and overall survival (p = 0.9). Distinctive chemokine expression was identified in positive patients studied and was not observed in negative patients (×2 p = 0.008). In the experimental study, only the LLC lung cancer cells were detected in the urine cytology of mice.ConclusionThis phenomenon, carrying undefined pathophysiological mechanisms, seems to characterize only patients with metastatic/extensive disease and high tumor burden. Further studies are needed to validate our preliminary chemokine expression results. |
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Keywords: | Urine cytology Occult Urothelial metastases Lung cancer |
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